Friday, March 15, 2024

HONORING HEWLETT HOUSE & GERI BARISH- LONG ISLAND'S LEGEND IN CANCER CAREGIVING!

Introduction
In a recent interview with Long Island cancer support advocate, Ms. Geri Barish shares her uncompromising passion for her life’s work.  As co-founder of Hewlett House, Ms. Barish established a well-loved community learning resource center for cancer patients and their families. She and her staff have been serving the local community for over 28 years and have served tens of thousands of cancer patients and their families.

INTERVIEW with Geri Barish
“Hewlett House is all about human connection: since its opening in 2000, it has become a safe haven for cancer patients and their families.”  Their patients come together to network and receive accurate information in a comfortable home environment. The Hewlett House facilitates discussions that help patients come to terms with their cancer and treatments, all while maintaining strict HIPAA standards of privacy. Their services rely primarily on the generosity of our supporters and local communities.

I'm a five time cancer survivor and was originally diagnosed with breast cancer at 38.  I see people with cancer all the time and if I knew then what I know now, maybe I could have helped so many more.  What I say all the time is “you have to be screened! Cancer starts young.” It doesn't start at 50 and 60 and 70. It's not just an old person's disease. 

CANCER STARTS EARLIER
I'm fighting right now for younger women to be screened – and to know their history. We have too many young women in their twenties getting breast cancer. Our last meeting had 27 new patients, mostly under 31, either breast cancer survivors or still in treatment. I think that's pretty serious. When they come down with breast cancer, it's often very aggressive because they weren’t screened and didn’t know their history.  I am advocating to push for younger women to know their history and to get screened.

Part of this advocacy is addressing the need for people to get ultrasounds, and insurance isn’t always covering it.  When the doctor writes a prescription it should be adhered to. So when you go for an ultrasound it is often out of pocket, $3-$400. It is outrageous. Because of this, we just put together a bill with New York State Senator Steven D. Rhoads  that would require Breast Cancer ultrasounds to be covered.

Starting next week I am doing a radio program about exploring “what does early detection really mean?” … and what is the age group? I'm out there really pushing for younger and younger women to go to their doctor to be screened. If you feel something, if you know there's a history in your family, whether it's prostate cancer or another kind of cancer, you need to speak to your doctor. We're just seeing too many young people get cancer across the board. 






THE HOUSE BUILT FROM LOVE
The Hewlett House itself is a national landmark that was deeded to the Hewlett-Woodmere school district for educational purposes. Unfortunately the house had fallen into neglect and disrepair. County executive Bruce Blakeman had worked with me on cancer issues and thought I could have use for this building for our cancer patient support initiatives. He arranged for the legislature to buy the house for a dollar, and we took it over with major support from caring volunteers. We converted this 387 years old house into our patient haven. (See photo tour of the Hewlett House.)

We started out as breast cancer support, but today Hewlett House services all kinds of cancer patients. We see men, women, children and we have served over 37,000 people since we opened our doors. All services are free and we work with all hospitals. 

I sit on the advisory board for cancer at Mount Sinai Hospital and I'm a special assistant to the Commissioner of Health of Nassau County. I work for the health department. I also sit on the Medical Society board for Nassau County. My outreach goes everywhere - it doesn't stop at the front door of Hewlett house.

A PERSONAL CRUSADE – REFLECTING ON HEREDITY & “A LONG WAY TO GO”
For me, this all started when my son had cancer. In 1974 my son Michael was diagnosed with Hodgkin's disease, at the age of 13. In 1986, a week before he died, I was diagnosed with breast cancer at the age of 38. I remember coughing one night and I put my hand to my chest. I felt something hard and round like a pea. It was towards my clavicle. I thought, “God, I wonder what that was?” I was so involved with my son that I didn't even think about it. Looking back, my mother had died from breast cancer and I wasn’t making the connection. I was more concerned about Michael. Then I went to the doctor and he said, “no, it's very hard – let's try taking a biopsy”. Lo and behold, it turned out to be cancer. The day I was supposed to start radiation was the same day as his funeral. 

That was in 1986, and the breast cancer recurred in 1987. I had skin cancer in 1990. I had breast cancer again in 1993. In 2015 I had lung cancer. I just keep going because of my son. I made him a promise and I'm writing a book right now— it’s called “I made him a promise”. He asked me “what did I do wrong, why do I have cancer”. I said “you did nothing wrong”, and I promised him I’d find out why. I'm not going to stop. We've come very far and there's still a long way to go.


ENVIRONMENTAL MISSION
Our location allows us to work well with the five boroughs. We also work with a group of young women across the United States called the BREASTIES, all under 32. We had meetings a few times a year to discuss environmental impacts on cancer cases. 

We got together as an organization in the late eighties, when Long Island had a very high rate of breast cancer. We started talking about having an environmental study. We got together with Susan Love and we helped to start the National Breast Cancer Coalition in Washington. We marched and we met many people and we started asking questions. I met with the surgeon general asking the NCI for a $5M budget for an in-depth environmental study of Long Island due to the prevalent cases of breast cancer. It is an island with the most open waste sites. The study would need about $5 million. We were directed to Senator Al D'Amato and Congressman Peter King. They helped start our five year in-depth environmental study on water, pesticides, chemicals, and much more. It became known as the Long Island Breast Cancer Study Project.



THE WOMEN'S HEALTH COLLABORATIVE gives special thanks to Ms. Geri Barish for a lifetime of generosity, endless support and loving care for all those who have entered the doorway of the Hewlett House- and for the many who call on her for help and resources while battling debilitating diseases.  Since 1990, the mission of Hewlett House is to support cancer patients at every stage of treatment. Ms. Barish and all her volunteers manage this special community resource center that provides all services without charge. They pride themselves in providing patrons with the highest-quality information and guiding them throughout their battle with cancer. Every patron is treated like family and given full access to educational materials, 24/7 peer-to-peer support systems, and a network of cancer survivors and doctors. Hewlett House is open to those fighting cancer and their families. A variety of free services are available, including yoga, meditation and tai chi classes, support groups, wigs, bathing suits, bras and informational services.  For more information, visit: https://hewlett-house.org/ or call 516.374.2385




A COMPLEX INTERACTION & ENVIRONMENTAL TOXICANTS
By: Dr. Roberta Kline
Not everyone who is exposed to environmental chemicals will develop disease or cancer. The outcome for each individual is the result of a complex interplay of their genetic predispositions, epigenetics, and environmental exposures over their lifetime. We all have biological processes to clear many different chemical substances from our bodies. How well these systems function can be affected by many factors, including genetics and epigenetics, along with a person’s health and nutrition status, exposure level, and even stress. The more suboptimal these are, the higher a person’s risk for consequences to their health from environmental toxins.


NYCRA NEWS- Genetic Predisposition (with Special Video PSA by Dr. R. Kline)
By definition, diseases like CANCER are not directly hereditary. Unlike genetic traits and characteristics passed down to children like blood type and eye color, chronic diseases like cancer are recognized to be contracted through the environment (external impact). However, as cancer is a form of genetic mutation, genetic changes that increase the risk of cancer CAN be passed down or inherited.  


Many organizations fundraise through golf club outings and things like that. We thought to do better- by bringing families together under one roof for a memorable night of "joyful noise".  The concept of the Musicfest is an event that we started producing 15 years ago as a fundraiser to support the Are You Dense? mission. For many years, we have done legislative work while bringing awareness and education to the public about the cancer concerns linked to Dense Breast Tissue. The Musicfest was our largest finance producer and we need it every year. It's very exciting to have bands from all over the country come in to perform-- both well-known and not-so well-known groups. 







WE ALL NEED MENTORS

I had the pleasure of finally meeting the legendary GERI BARISH and THE HEWLETT HOUSE. After one phone interview, Geri's commitment to advocacy and resource giving sparked a unique level of curiosity about her work to see her magical HOUSE on East Rockaway Road for myself - and I'm so glad I did.  From the front steps to every room inside the hallowed house, the love and compassion was literally sprinkled everywhere.  Geri's historical tour included some of the most heartwarming highlights about some of the individuals who lovingly called this place a second home - including those whose lives were cut short by the dreaded disease.  As the director of the NY Cancer Resource Alliance & Firefighters Against Cancer & Exposures (as well as being a fellow Long Islander), I have always known about Geri's work going as far back as 2001.  Admittedly, I never thought my level of philanthropy could ever compare to her achievements or her unending level of commitment.  But having finally met her, I was almost reduced to tears having personally felt Geri's brand of kindness and leadership to help ANYONE in need. As a 5-time cancer survivor herself, Geri understands the emotional tolls and the need for resources that a sufferer undergoes.  There is truly no limit to her will to share and give and help.  At long last, I join the many voices of appreciation and gratitude for Geri Barish - the ultimate role model for altruism, benevolence and moxy for making a difference!  She wins the lifetime 'cats' pajamas' award for "amazingness"!


This feature is sponsored in part by:













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Wednesday, February 28, 2024

A QUANTITIATIVE ANALYSIS & IDENTIFYING THE KILLING CANCER

Written & produced by: Dr. Robert Bard

INTRODUCTION
I'm a radiologist subspecializing in ultrasound imaging, and I've been doing breast scanning for over 35 years. We have advanced radiology from x-rays to ultrasound to MRI and beyond. Reports are now promoting certain cancers should be considered as chronic diseases instead of "killing" cancers.  We have known this for the past 30+ years that some cancers are dormant and while cancers are actively lethal. 

We've learned that some breast cancers are low-aggressive (but we need to continually watch them) or perhaps call for less aggressive treatment.  We've also learned that certain cancers may surprise us; they do not follow the expected guidelines due to continung mutation.  An example of this is the new findings of breast cancer cases in younger and younger ages (ie. 19 to 22 years old), and this age limit continues to get lower and lower.  

The same thing goes with breast cancers in men; five years ago, the count it used to be 1% of the population of cases, and now it's risen to 2% of the breast cancer population. We're finding more of it, partly thanks to better imaging access and partly because of improved awareness. 

Imaging innovations not only offers better detection but once we have the image, we can see if this is a "killing cancer" or not. The simplest technique and most basic technique is to use blood flow imaging. If we find many tumor vessels, "tumor's bad". If the tumor has only a few tumor vessels, tumor is "not so bad". More importantly, if you're treating a tumor and it goes from less to more, the treatment is not working. So we have a way of monitoring treatment in real time. 


PRESENTATION:

Slide 1- shows a mass under the arm that is measured externally and internally. We employed 3D Doppler blood flow (for PreOp scan or prediagnostic scan) to find out where the cancer is and focus on that. We target before, during, and after treatment scan points. The slide also shows the blood flow readings- showing very few tumor vessels, which is a good sign. This indicates our new  ways of targeting tumor aggressiveness. 





Slide 2 shows a gland, allowing us to determine whether it is normal or abnormal. Clinically, this was a fatty tumor 'cause it was smooth and, and moved. But if you look carefully, it was not a breast cancer metastasis, but it was a, a primary cancer of the glands or the the bloodstream, which is useful. But again, it's radioactivity, it's isotopes. It, uh, takes a long time and it's expensive. 


Slide 3-  shows a mass and then we have a color on the far right slide, which is new for us because it's not a blood flow technology. This is elastography. When you feel a cancer, it's often hard like a piece of rock, whether it's in the breast, the prostate, the in the neck. And this is a non-invasive way of looking at tumors. It's called elastography because it shows the elastic nature of tumors. So if a tumor is rock hard, it's highly inelastic, and if it's soft, it's more elastic. 

And this is a quantitative technology that's used globally for the last 15 years. So we now have ways of seeing what a tumor is, where it is. And globally, people are deciding whether or not to biopsy a breast if there's nothing showing up by an ultrasound or ELAs that looks suspicious. And the Doppler blood flow is, looks, uh, either low grade or benign. So this is a, a filter which is just being recognized by the insurance companies and paid for now to decide whether the biopsy or not. Also, if the tumor is hard, like the, the vessels going into it and it becomes soft with few vessels and less elastic or less, uh, red in it on the gram, we have the ability to say that the treatment is working non aggressively without doing biopsies to see if it's gotten better or worse. 

So we're learning that biopsies can be hit or miss in the getting. They can be hit or miss in the sectioning. They can get the hit or miss in the interpretation at the end. Sorry to say that this is a problem, but you have to realize that the reason we went to advanced imaging is because it's safe, it's quick, it's repeatable without needles. Using the imaging, which I repeat is done globally now, to avoid biopsies and to avoid re-biopsying lesions to see if the treatment is working with the blood flow technology. The 3D Doppler, the advanced equipment will show you where the tumor is, what's happening to it. And once you see the blood vessels, you also have other options. For example, in if you have blood vessels feeding a tumor, now you can stick a catheter in the artery that's feeding the tumor and destroy the whole tumor by blocking the blood supply. 

Needle Biopsy (sample)
It's called infarct the tumor- used also in treating fibroids. Now we're treating certain cancers. You just kill the blood supply to the tumor if you know where it is. So these are options that weren't available before and are being accepted by medical community. For example, if there's a tumor in the breast, we look at the tumor, but then what next? The patient is sitting in front of you. So you may want to look under the arm to see if it's spread. And of course if you find it's metastasized to lymph nodes under the arm, you may say, and again, the patient's right in front of you, where else could it spread? Because treatment of disease that's only in the glands is different from treatment of cancers that spread to the well to the lymph nodes in the body or to the uh, liver for example. 

So it's a completely different approach. So then we ask the patient to lie down, put the probe over the lymph nodes over the aorta, the main blood vessel in the midline, and then we check the liver and then the other areas that can be affected. We can also look at the ribs to see if there's erosion of the bone by tumors, which commonly wind up in the rib cage. So we can do all of this at the same time. The patient is in front of us. 



ROBERT L. BARD, MD is internationally recognized in the field of 3D DOPPLER ULTRASOUND IMAGING to detect cancers (in organs including the breast, prostate, skin, thyroid, melanoma and other areas). As a certified diagnostic radiologist, Dr. Bard evolved his practice to pursue non-invasive 3D imaging with ultrasound, MRI and laser technologies. He is also passionate about conducting educational presentations and publishing in International Medical Journals. He holds Board certification from the American Board of Radiology (1974) and Fellowship in the American Society of Lasers in Medicine and Surgery (2014).  https://drrobertbard.com/

Friday, January 26, 2024

27 Year Old Stage 3 Breast Cancer Victim Survived - Despite of Docs Who MISDIAGNOSED!

 

The Women's Health Collaborative and EARLIER DETECTION advocate Alexandra Fiederlein interviewed breast cancer survivor Jamie Butera about her journey to getting checked to save her own life.  When her own doctor said, "You're Way to Young for it to be Breast Cancer"- Jamie's instincts told her different.  By 'demanding' the right screening and tests, she found that she had Stage 3 breast cancer. "Be your own advocate, get the answers you deserve... if I didn't seek answers when I did, I would only have had 2 months to live!"


INTRODUCTION
FACT: Cancer does not discriminate. And this includes healthy people, people that are physically fit and active and young women.  In general, young people think they're bulletproof. Well, you are not! You look at the camera as one of the young people, but you're one of the smartest generation young people and say, "take it from me. Young people can get cancer just like older people."

In the case of Jamie, I'm glad she was proactive enough to follow her gut - instead of doctors who guess wrong!  Jamie is a survivor of stage three breast cancer and is a supporter of earlier diagnosis. Jamie's strength is an inspiration for many, and her story is a reminder of how women should be advocates for their health because their lives depend on it. Jamie is also the owner and operator of a full service WIG Salon called the Wig Nook located in Las Vegas, Nevada. Her services play a special focus on cancer patient survivors and those struggling with alopecia. And Jamie is also an active member of the Hidden Angel Cancer Support Group.


JAMIE'S TRANSCRIPT
In the year 2015, I was diagnosed with a stage three breast cancer on my right breast. It was a triple negative. When I did my own research, it just really means it tested negative on three aspects of tests with (I believe) estrogen.  

It all started when I found a lump in my right breast. It was a very small lump, about the size of a grape. When I initially felt the lump, I went to an ER and saw a doctor there. They told me that they don't really deal with that... I have to go see my gynecologist- who told me that it could be an infection of a milk duct because I was way too young for it to be cancer. So she told me I shouldn't be concerned at all! She told me I shouldn't be concerned at all. I'm way too young. So she put me on antibiotics to see how that would go.

I feel if I didn't follow my intuition or demand answers (since I found this lump), I wouldn't be here today because records have shown when we're younger, they don't really take it as seriously. I would say be your own advocate! Get the answers you deserve because there is always a cause. If you have a lump, obviously there is a cause for it. So even if they tell you otherwise, keep asking and keep digging for answers.  Find out the cause of this lump and more importantly, find out what it really is!

So from my understanding, this was an aggressive kind of cancer- so I started chemo right away right after I got diagnosed.  It took them about two months before my being initially diagnosed because they didn't really think I had the breast cancer because I was very young (I was 27 at the time). By the time I was diagnosed, I started with intense chemotherapy then followed by radiation then surgery.  Seven years later, I'm still cancer free.  

SURVIVOR'S ADVOCACY
Years later, after my diagnosis, I chose to go public and be really open with my diagnosis. I put my story on social media. I let people see me without my hair. I didn't want someone to go through the same thing I went through or someone to possibly die because they weren't diagnosed early enough because they were too young. U

I host the Hidden Angel Cancer Support Group so people don't feel alone with this cancer.  It made me feel really good to speak to survivors at the time when I was going through it myself.  I feel like being involved with cancer support groups help you to see (especially survivors) that if somebody else has survived this, I too can survive it!



SURVIVOR TURNED RESOURCE FOR PATIENTS & SURVIVORS

Another wig salon opening in Vegas?  Well the Wig Nook is not just any new salon.    The Wig Nook by Jaime  is full service to all wig designs and fittings but thoughtfully designed from one survivor to another.   While we offer a large wig selection, custom fitting and cuts, steaming and cleaning, we offer the comfort and care of someone who "has been there and back" as a cancer survivor and is dedicated to a comfortable and inviting setting for our clients.   

The Wig Nook offers other board licensed expertise in Hair Extensions and Hair Styling to all your needs.  We are proud to announce that we offer Nail Service to our list of services. With all these exciting professional services, we want you to Meet me at the Nook!  At The Wig Nook,  we pride ourselves to have a true connection with our clients.   As a Stage 3 Breast Cancer survivor, owner and lead stylist Jaime Butera is dedicated to provide specialized wig services with the care that a cancer survivor is looking for and deserves.  She offers various hair services including the highest quality wig services



WHAT ABOUT IF YOU'RE TOO YOUNG FOR A MAMMOGRAM?   I went to my doctor for a lump I felt in my breast and she gave me a response that set off red flags: "don't worry about it". Being a researcher involved in breast density and breast cancer, I knew that I had to take action; I was fortunate enough to have my breast ultrasound training with Dr. Robert Bard (cancer imaging specialist, NYC) upcoming in the next week. Dr. Bard showed me how to use the ultrasound to help me find two benign tumors in my breasts, and it was there that he reported that I have dense breasts. Had I not taken action in getting screened at the young age of 22, I would have never known that I should be getting screened via ultrasound every 6 months (because having dense breasts puts me at a higher risk for breast cancer), nor would I have known that I had benign breast tumors. 

- ALEXANDRA FIEDERLEIN, 22
Cancer Researcher/ Graduate- Molloy Univ.

Saturday, December 16, 2023

PATHOLOGICAL VIEWS OF DENSE BREAST TISSUE

Written by: Dr. Robert L. Bard  (12/2023)
Edited by: Carmen Regallo-Dewitt

Decades since the advent of breast scanning technology, innovations in non-invasive diagnostic imaging provide new options in the field of early detection.  A mammogram can show how dense your breasts are including how low or high in density. However, over-compression artificially lowers the radiographic density.



 [Image 1] in this standard mammogram, a dense breast is presented side by side. The white shaped “V” that comes down the top center are the pectoral muscles of the chest wall. On the far outside, the white line is the skin outline of the breast. This is the dermal tissue causing the white line viewed enface.  Radiologists always study this for any indication of inflammatory disease of the skin or inflammatory breast cancer, which manifests itself in skin thickening.  Between the center wedge and the skin outline, you will find homogeneous cloudy areas with patchy black spaces within as an example of dense breast tissue. 

Usually, dense breast tissue appears white on a mammogram. We must identify them as one of two forms of breast density; one is called FIBROCYSTIC or fibrous [Image 2] which is homogeneously white. Occasionally you can see a branching of blood vessels, dilated ducts or a streak of fat inside the dense breast tissue. This is the most common type of dense breast tissue and generally seen in the over 40 population.

[Image 3] Another example of a dense breast shows the difference between homogeneous white versus the whitish area. This is filled with dark, wormy looking structures, which are the breast glands called GLANDULAR tissue. This kind secretes milk and its glands are often dilated. Both Fibrous and Glandular may appear similar under a mammogram as highly dense areas, but they look completely different under an ultrasound scan.  

Through ultrasound, we can check for tumors easily through fibrotic dense breasts because it stands out as a black region (or a black hole) within the white area. As shown in Image 3, a black hole could get lost, making it more difficult to image this type of dense breast.  In this case, a solution is the use of elastography [Image 4], which offers visual confirmation as indicated by color data. Elastography can measure tissue density (its hardness or elasticity) within the glandular breast tissue. 

This tissue type is more common in the under-40 age group and is associated with other glandular proliferation such as endometriosis and is reportedly linked to dermal inflammation. In published reports, comparative studies between FIBROUS and GLANDULAR breast tissue studies remain limited.  We are observing (especially in the younger age groups) expanding reviews of these types of tissue density aligned with the rates of breast cancer to confirm the rate of malignancy in tissue alteration from normal.





TRIBUTE TO A GLOBAL CRUSADER
(Play Video-L) The NY Cancer Resource Alliance gives loving tribute to Dr. Nancy Cappello, co-founder of "Are You Dense" and chief crusader of the mission to bring change to the protocols and standards of Early Detection.   Her organization embarked in a global advocacy project to win legislation for dense breast scanning and to bring awareness to the need for better technologies and imaging interpretation. Today, her loving husband Joe continues her unending fight to save more lives through awareness, advocacy and her crusade for change.  (Also see below to read her full story in our ORG SPOTLIGHT section)



Epigenetic Research Notes: Profiling the Dense Breast Paradigm (part 1)

 Coursework (Part 1) written by: Dr. Roberta Kline


As an Ob-Gyn physician and genomics specialist, I have spent the better part of 10 years translating research in the genomic and gene expression areas into clinically usable information for healthcare professionals. One of the biggest challenges we face when connecting research with patient care is the long delay in the translation process and dissemination of the information. It often takes 10 to 20 years for information (validated findings) that comes out of research to be applied in clinical practice. These delays result in many lost opportunities to provide better care for our patients. This is one of the reasons why I'm really passionate about accelerating this process and making it easier for clinicians and their patients to take advantage of cutting-edge information and new technologies. 

LINKING DENSE BREAST WITH BREAST CANCER

We have known for a very long time that there is an increased risk of breast cancer for women who have dense breasts. Until recently, the research has been lagging in terms of what's the molecular mechanism, why do dense breasts present an increased risk of breast cancer? Without this knowledge, we can’t address the root causes, and are left with a lot of trial and error based on incomplete understanding.  (see complete report)



LIVING WITH ENDOMETRIOSIS:
From an interview with MJ Smith

My personal and professional missions are both in women's health. By day, I work for a breast AI company focused on helping radiologists find breast cancers on mammograms. I chose this path because I believe in advancing causes that support women's health simply because women are core members of our culture and our families. I have had two family members, both maternal aunts, who died of breast cancer, - one at the age of 36, and an the other at the age of 52.

Advocacy for Endometriosis is directly related to my personal journey. Growing up with endometriosis since puberty, I've been to the emergency department probably over 20 times for pain or pelvic pain related conditions. The pain had me flat on my back for days at a time or falling out of bed with pain.  I drove myself to a Planned Parenthood in Minnesota where I grew up and was prescribed birth control to manage it well into my twenties.  Despite the hormonal treatments, I still had a series of episodes. 

Endometriosis is the uterine tissue that grows and implants itself outside of the uterus. Going through that pain is the result of a complex process, resulting in swelling and bleeding inside the interstitial spaces of my body. Women who have endometriosis also often develop painful cysts on their ovaries. 

I think the biggest reason you see women in the ER is pelvic pain. Women with chronic pelvic pain (which is often what endometriosis causes) are underserved by the healthcare community because we're constantly complaining of pelvic pain.  The ER is not where you want treatment because you see a different doctor every time you get admitted. With emergency imaging, you usually get a pelvic ultrasound where cysts can show up and they're quick to assume that you have a cyst, or a cyst has burst and this is why you're uncomfortable.  I think now you can do a pelvic MRI with contrast media- but it's still not enough to offer a definitive diagnosis.  (See complete report)





Decades since the advent of breast scanning technology, innovations in non-invasive diagnostic imaging provide new options in the field of early detection. These technologies directly align with breast density screening (and are part of the Bard Breast Density Diagnostic Program).








CONTRIBUTORS

ROBERT L. BARD, MD  (Diagnostic Imaging Specialist)
Having paved the way for the study of various cancers both clinically and academically, Dr. Robert Bard co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- www.CancerScan.com) uses the latest in digital Imaging technology has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. His most recent program is dedicated to the reporting of mental health diagnostic and innovative solutions including the use of modern neuromagnetic technologies and protocols in his MEDTECH REVIEWS program. 



ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group)
Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://bobbiklinemd.com 






Copyright © 2023- Robert L. Bard, MD & cancerscan.com. All rights reserved.


Friday, December 8, 2023

"EARLIER DETECTION"- REACHING A GENERATION IN CRISIS

 

By: Alexandra Fiederlein (23)  | Edited by: Dr. Roberta Kline and the ICRS Editorial Team


I belong to the graduate-level age group that continues to witness the increasing numbers of breast cancer cases in our country.  The women in this generation also happens to be the next group that falls prey to being UNDERDIAGNOSED. Insurance companies and the medical community have made little or no action to support or identify the need for women in their 20's and 30's to be approved for  standardized early detection / breast cancer screening.  

From the front-row perspective, younger women are as much at risk of getting cancer. Reports show an uptick in genetic predisposition for breast cancer*, alongside a dangerous attitude of denial. Addressing this calls for widespread education and screening programs in our community as essentials to a life of wellness and prevention.  To subscribe to a regular screening routine at the early stage of womanhood raises awareness and prevention for decades to come.  Perhaps someday, installing breast cancer screening centers in  college campuses may be commonplace and a powerful step toward a national prevention initiative.

CURRENT DATA FROM PUBLIC SURVEY
Assembled by Dr. Roberta Kline, OBGYN & Co-Editor of Women's Health Digest

Source: CDC (link)


Enclosed is research-based public information by the CDC that widely supports the current reality about new cancers (including breast cancer) in women under 40.  The data used by public health comes from a wide variety of places within our local communities: hospitals, laboratories, doctors' offices – anywhere that a person receives healthcare.

Age-specific rates breast cancer for 2020 (Total for ages 20-39)
Rate of new breast cancers = 27/100,000
Equals 11,368 new cases/42,765,288 women

Details:
<20: numbers less than 16 cases for lower age categories, data suppressed
20-24: 1.7/100K; equals 174 new cases/10,239,813 women
25-29: 10.4/100K; equals 1,146 new cases/11,016,549 women
30-34: 30.5/100K; equals 3332 new cases/10,939,868 women
35-39: 63.5/100K; equals 6716 cases/10,569,058 women



(Continued)

Click to download the latest ACS report
Targeting the young working PROFESSIONAL is a major part of our population, where the vast majority tends to put off checkups and screenings because they are just "too busy". Professional women need to value their health above anything else, and therefore the narrative needs to be amplified in that area. We find this problem to be quite prevalent in urban areas with the constant on-the-go culture. Offering local resources and improved access for personal scanning are just some progress driven programs. 


GEN Z is a sensible focus group because these are the women who absolutely must receive routine scanning. We need to advocate for the narrative that age 40 is not the starting age where screening needs to begin- especially since we are now seeing cancer cases in younger ages are growing in numbers. Getting OB/GYN professionals on board is especially important because this is where women are getting their prescriptions. 

We need to educate on the benefits of ultrasound. People need to know HOW it works, WHY it works, and why it holds certain benefits over a mammogram. People need to know that it is SAFE and EFFECTIVE, and this technology can save lives. I think it is especially important to emphasize the option of ultrasound for younger women. Many younger women have dense breasts and don't even know it, putting them at a greater risk (I wouldn't have known if it weren't for all of you!). Ultrasound is obviously a safe and effective screening method for young women. It is also not linked with the stigma/fear of getting a mammogram like many women my age hold (X-Ray exposure, etc.). 

If the drive for EARLIER DETECTION means proactive awareness, may this lead to turning social concern into clinical action.  This includes clinicians joining hands with advocacy groups who recognize the many potential areas for at-risk women in my generation whose lives and safety continue to go unrecognized. And once the count of cancer cases and deaths rise exponentially due to inaction, perhaps then will the medical community find urgency in upgrading the required breast cancer screening age to (finally) include generations like mine.  So say we all! 

Ref:
*Global Increase in Breast Cancer Incidence: Risk Factors and Preventive Measures, PMC9038417. (NIH)- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9038417/

This article is sponsored by the educational program of Bard Diagnostic Imaging


WHAT ABOUT IF YOU'RE TOO YOUNG FOR A MAMMOGRAM?   I went to my doctor for a lump I felt in my breast and she gave me a response that set off red flags: "don't worry about it". Being a researcher involved in breast density and breast cancer, I knew that I had to take action; I was fortunate enough to have my breast ultrasound training with Dr. Robert Bard (cancer imaging specialist, NYC) upcoming in the next week. Dr. Bard showed me how to use the ultrasound to help me find two benign tumors in my breasts, and it was there that he reported that I have dense breasts. Had I not taken action in getting screened at the young age of 22, I would have never known that I should be getting screened via ultrasound every 6 months (because having dense breasts puts me at a higher risk for breast cancer), nor would I have known that I had benign breast tumors. 

- ALEXANDRA FIEDERLEIN, 22
Cancer Researcher/ Graduate- Molloy Univ.




A major concern is the presence of breast cancer in underserved communities, including those TOO YOUNG FOR A MAMMOGRAM.  Whereby the medical community touts the recommended (and legal/billable status) of getting a mammo scan should be between 40-50, what happens to the many women who do not fit this age criteria?  How would they even know to get checked without the support of their clinicians or an alarm from family history? Decades into the battle against breast cancer, clinicians and the public are much more educated about EARLY DETECTION, PREVENTION and the current protocols and modalities available to save lives.  Recent headlines on DENSE BREAST and the advancements in ULTRASOUND SCANNING supports a major part of this battle. SEE COMPLETE FEATURE


WATERBURY, Conn. (October 12, 2023) JOE CAPPELLO/ARE YOU DENSE? FOUNDATION RECEIVES KEY TO THE CITY FROM MAYOR O'LEARY
Waterbury celebrated a citywide Pink Out on Thursday, October 26th! Saint Mary’s Hospital Foundation has once again partnered with the City of Waterbury to recognize Breast Cancer Awareness. Waterbury Mayor Neil O’Leary, Saint Mary’s Hospital President, Kim Kalajainen and special guest Joe Cappello will address organizers and volunteers from the Waterbury Police and Fire Departments as well as the Education Department, area students and others at 11:00 a.m.  at Waterbury City Hall.  


Video News Release: Innovations in Early Detection

"Are You Dense?" Foundation Co-founder Joe Cappello joins the medical diagnostic community to promote the "Get Checked Now!" campaign. Dr. Robert Bard from the Bard Cancer Center (NYC) supports supplemental imaging including the 3D Doppler Ultrasound scanner to offer dense breast detection.  This video presents some of the latest advancements in ultrasound features to detect tumors through dense breast tissue- reportedly a significant challenge with mammograms. 




GO "EARLIER" WITH EARLY DETECTION (FOR WOMEN AGES 20-40)
According to the American Cancer Society (ACS),  women ages 45 to 54 and post-menopausal years are required to get mammograms every year.[1a] But for the underserved ages (20-40), the risk for breast cancer exists in growing numbers. In support of Breast Cancer Awareness month, the Integrative Cancer Resource Society, the AngioFoundation Institute (501c3) and the "Are You Dense?" Foundation  addresses the continuing concerns for breast cancer in the New York area by recommending early detection screening programs for women over 20 (and not just anyone 40+ as standardized by the insurance companies.

The medical community has identified over 5% of all breast cancer cases occur in women over 20 and under the age of 40. The increased risk for breast cancer in dense tissue also exists and is identified by the medical community.  Diagnostic Imaging specialist Dr. Robert Bard of NYC identifies the need for paying more attention to breast cancer screening to ages younger than the mandated 40+.  "It's about time the (medical) community recognizes the growing rate of breast cancer in women of younger ages... from genetic predisposition to geography to having dense breast tissue, earlier detection should be our next national initiative."

Breast cancer in younger women may be more aggressive and less likely to respond to treatment.

Women who are diagnosed with breast cancer at a younger age are more likely to have genetic mutations predisposing them to breast and other cancers.

Younger women who have breast cancer may ignore the warning signs—such as a breast lump or unusual discharge—because they believe they are too young to get breast cancer. This can lead to a delay in diagnosis and poorer outcomes.

Some healthcare providers may also dismiss breast lumps or other symptoms in young women or adopt a "wait and see" approach.

Breast cancer poses additional challenges for younger women as it can involve issues concerning sexuality, fertility, and pregnancy after breast cancer treatment. [1]


2) INCLUDE SUPPLEMENTAL SCREENING FOR DENSE BREAST TISSUE (WITH HIGH RESOLUTION ULTRASOUND): Women diagnosed with dense breasts should continue to get regular screening mammograms. But there are additional screening tests that can help doctors detect tumors that may not be identified by conventional mammography or DBT. [2]  Any woman who has dense breasts may want to consider supplemental screening, usually with breast ultrasound. Studies show that screening with ultrasound, in addition to mammography, improves detection of breast cancers in women with dense breasts. [3]

3) WHOLE BODY MRI (NO CONTRAST) FOR CANCER SCANNING: In simplistic terms, having a full-body access comports to the fact that everything is connected in one way or another.  Our full-body MRI provides early diagnosis and the largest view of the body, where finding any cancers in the body and/or where they may spread can provide the best chance of treatment success.  In suspected cases of early breast malignancy, the exclusion of metastatic disease is clinically vital and emotionally supportive.

1a) "Infographic: 7 Things to Know About Getting a Mammogram"- ACA/American Cancer Society: https://www.cancer.org/cancer/types/breast-cancer/mammogram-tips-infographic.html#:~:text=Women%20between%2040%20and%2044,choose%20to%20continue%20yearly%20mammograms.

1) "Breast Cancer in Young Women"- Cleveland Clinic: https://my.clevelandclinic.org/health/articles/16805-breast-cancer-in-young-women

2)  "What additional breast cancer screening tests are available for women who have dense breasts?"- Yale medicine- https://www.yalemedicine.org/conditions/dense-breasts#:~:text=Women%20diagnosed%20with%20dense%20breasts,(whole%2Dbreast%20ultrasound).

3) Columbia Doctors/ "What Are Dense Breasts? A radiologist offers guidance":-Health Insights: October 14, 2022 https://www.columbiadoctors.org/news/what-are-dense-breasts#:~:text=Any%20woman%20who%20has%20dense,in%20women%20with%20dense%20breasts.






"In order to catch cancer, you need to be able to detect it at an early stage so we can treat patients with the most effective mechanisms.  Ultrasounds are an easy, cost-effective method for screening for early breast cancers, especially in women below the age of 45, who are likely to have dense breasts. When you are young and premenopausal your breasts are dense and we know that breast density is linked to cancer and which also makes it harder for cancers to be seen on a mammogram. Although breast cancer is rare in women under the age of 40, early detection is key.  Public health campaigns are spending so much money on mammograms for this population of women who can easily and cost effectively be screened using an ultrasound."

"I LOVE this new program! Early detection is essential! There is a stigmatization around mammograms that they are painful and frightening. There is anxiety while you wait for the results. And, don't forget the appointment scheduling hassle.  Women, particularly younger women with active lives, small children, careers don't want to have to fit one more thing into their hectic and demanding schedules. However, mammogram technology itself has advanced and it no longer has to be a painful experience. Clinics and imaging centers are offering untraditional scheduling opportunities, such as very early morning appointments to late evening appointments that are timed for very minimal wait times. And, clinicians are often prioritizing mammogram interpretations so the results are back within 24 hours. The Self Care message is trending right now. Mammograms should be a part of self care."

HONORING HEWLETT HOUSE & GERI BARISH- LONG ISLAND'S LEGEND IN CANCER CAREGIVING!

Introduction In a recent interview with Long Island cancer support advocate, Ms. Geri Barish shares her uncompromising passion for her life’...